What will give the best results for flat stomach if I have a roll below my ribs and another below my belly button? (Photos)

liposuction is always better than coolsculpting or trusculptID. if you have loose skin it will need to be tightened and/or removed.

my whole practice is doing lipoabdominoplasty, or at least liposuction with internal heating (which is not the gold standard for skin tightening with body contouring).

the smaller you are before liposuction the more contouring you can get from the procedure. most of my liposuction patients get pre and post surgical peptides and hormones.

You need a formal evaluation by an expert in body shaping and contouring to determine what is best.  Traditional liposuction awake and smart liposuction are old methods and do very poorly for tightening skin or significant skin tightening or contouring.  Small problem areas can be improved slightly by these methods.  The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heat the skin with radio-frequency devices such as J PLASMA/RENUVION, InMode BodyTite, ThermiRF to heat the under surface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HIDEF VASER contouring and can only be done by a well . trained body contouring specialist. At the same time fat should be harvested, PRP and stem cells added and injected into muscles or indentations/cellulite to get body shaping and contouring.  This is known as a Brazilian butt lift when you inject the fat to the buttock for contouring and lifting, but fat can also be used in areas such as the chest/breast, arms/shoulders, calves and face.  Cellulite should also be treated with cellfina, sculptra, subcision and/or fillers such as bellafill, renuva synthetic fat, or sculptra.  If skin is very loose before surgery then it will need to be removed such as lower abdominal skin (tummy tuck/abdominoplasty), breast skin (breast lift), arm skin (brachioplasty).  Overall you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting.  Dr. Emer.

Hi, A weight of 5 pounds should not cause the loss of any benefit seen after a treatment but CoolSculpt is notorious for less than optimum outcomes. Traditional liposuction that is office based to reduce costs is reliable like no other modality. Best of luck.

If you are not planning future pregnancies, I recommend abdominoplasty with mesh reinforcement. The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.

Best Wishes,

Gary Horndeski, M.D.

Don't waste money on coolsculpting , Just get tum. lipo and bodytite RF and enjoy the great new tummy and waist line. It would make a dramatic improvement and it is so worth it.

You would need to be evaluated, but it seems liposuction would be an appropriate procedure for your abdominal issues.

Hi and thanks for your question. Based on your photos, you are good candidate for vaser liposuction. Your skin quality is good, and you don’t have skin excess. For this reason, vaser liposuction can be done for your tummy, sides, upper and lower back. With this combination you can get slimmer and athletic belt appearance. If you want, aspirated fat can be used for increasing your butt size (Brazilian Butt Lift). Total operation takes 3-3,5 hours. After the surgery you should use corset (compressive garment) for six weeks. You can see 80% of your final results 2-2,5 months after the surgery. In my practice I prefer the combination of vaser (ultrasonic liposuction) and microaire ( power assisted liposuction) by this combination we get more smooth liposuction appearance. I also recommend JPlasma for skin tightening After the surgery you should get lymphatic drainage massage. This massage is very important for proper recovery.
 
Best of lucks.

Dear OceanOracle,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would benefit from liposuction. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

You appear to be a great candidate for liposuction to target your rib and lower abdominal area. If you want to use the fat and place it elsewhere such as your buttocks and hips, then you can go ahead with the BBL which is simply liposuction with fat grafting. Hope this helps!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon

Hello, thanks for your question and photos. Coolsculpting or Cryolylisis is a non-invasive procedure for eliminating fat deposits with a cold device that "freeze" the fat and make it dissolve into the body. In your case, you can get the best results with Liposuction. Using J-Plasma /Renuvion, you can stretch your skin for getting a flat stomach. Consult a board-certified plastic surgeon in your area. Good luck!

I do not recommend cool sculpting as an effective way to remove subcutaneous fat.

For that liposuction is the gold standard and should be patience go to option or choice.

Most likely the reason you fail to see improvement from weight loss in your trouble areas is because skin laxity is creating the contour. This is for sure the case regarding the skinfold on your lower rib cage below your breast. You can see for yourself that they are young will flatten out nicely if you grab the skin just above it(basically grab your own breast) and pull up.
There are skin attachments along the base of the rib cage that anchor the skin and will not let the skin drop further because of gravity. Because of this the skin forms a fold in this area. The same fold continues onto the backside and patients will have a back bra roll
To correct abdominal skin laxity the full tummy tuck is the correct procedure. This may be more than you want to undergo so it becomes more tricky to give it a recommendation of something that’s actually going to work without doing the definitive procedure.

If you can muster the courage to do a full tummy tuck and that will fix all the problems but obviously it’s an exchange for a fairly big procedure, tough recovery, long scar and potentially unnatural looking belly button. in your area I have been immensely impressed by the work done by Mark Kobayashi MD.

If considering a tummy tuck the procedure needs to be modified and the separation of skin and fat from the underlying muscle layer needs to continue up onto the rib cage all the way to the inframammary fold. Doing so will free the skin attachment ligaments that are causing the bulge on your lower rib cage.

Fat removal alone preferably with Liposuction is going to be limited in fixing contour issues related to skin laxity. To differentiate between skin laxity and subcutaneous fat pull up and make the skin tight just above the problem area and you can see for yourself the impact that skin laxity has on contour.
These are some general recommendations for patient seeking cosmetic surgery.
1. I recommend patients avoid traveling long distances for elective surgical procedures. There are of course instances where there is a lack of local talent and traveling to some degree is inevitable. If traveling for the procedure patients should be ready to travel to have the consultation, post operative appointments and follow up should there be issues or complications.
Patients sometimes do not appreciate the importance of in person consultations, that complications do happen or the number of people who have issues with their results or need revisions.

2. Schedule multiple consultations with different providers in your area who seem to have a good reputation for the procedure you’re interested in. Starting with at least five consultations seems like a reasonable number to me.

3. Whenever possible schedule in person consultations.
4. During in person consultations ask each plastic surgeon to show all of their before and after pictures for the procedure you’re interested in.

The goal is not to see the best results of their career but to get an idea of what average results look like and get some type of confirmation of how many of these procedures that provider has performed.

Ask to see results that were not as good as the doctor would’ve hoped for and talk about the differences in outcomes.

Honest and experienced providers should have no problems presenting this type of information.

A highly experienced plastic surgeon should have hundreds of before and after pictures for the procedure you’re interested in. At a minimum at least 20+.

5. Read all the reviews on various physician review websites paying close attention and avoiding providers with any significant number of justified negative reviews. Providers with an abundance of reviews often have aggressive marketing campaigns.

The plastic surgeons I respect most all have the single variable of not having justified negative reviews on their online profiles.
In my opinion justified negative reviews are far more telling than an abundance of positive reviews.

6. Avoid scheduling for surgery or making a deposit on the day of the consultation. Give yourself some time to think about the decision and make sure you finished all scheduled consultations before committing to having surgery that will permanently and irreversibly change your body.

When in doubt slow down and schedule more consultations.

Choosing the right plastic surgeon is the single most important variable to having a positive experience.

7. Don’t go chasing after technology or names of certain equipment. Instead focus all your efforts on finding the most experienced and talented board-certified plastic surgeon.

Best,

Mats Hagstrom MD